Perioperative medicine & outcomes
Optimal Timing of Perioperative Chemoprophylaxis in Patients With High Thromboembolic Risk Undergoing Major Abdominal Surgery: A Multicenter Cohort Study
Pooled result · Clinical VTEResult — go to the resultOdds ratio 1.11 95% CI 0.60–2.15Authors' conclusion
In high VTE risk patients undergoing major abdominal surgery, chemoprophylaxis commenced postoperatively reduces bleeding risk without affecting clinical VTE risk.
Study context
- Population
- High thromboembolic risk (Caprini score >4) patients undergoing major abdominal surgery
- Participants
- 5,501 participants · 5 multicenter studies
- Comparison
- Early vs postoperative chemoprophylaxis
- Earlyn = 1,752
- Postopn = 3,749reference
- Outcome
- Clinical venous thromboembolism (VTE) (radiographically proven symptomatic disease) and bleeding
- Follow-up
- <30 days postsurgery
Methodological detailspooled data
- Pooled data
Pooled result
Clinical VTE
Odds ratio
1.11
95% CI 0.60–2.15
P = 0.730
By group
Early vs Postop
OR 1.11 (95% CI 0.60–2.15); P = 0.730
As reported in the abstract
Further pooled results
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Early chemoprophylaxis as independent predictor of postoperative bleedingIndependent predictor; not of VTE | 1.71 (1.25–2.34) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Safety
| Outcome | Early | Postop | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| All bleeding | 5.1% | 2.6% | 2.04 (1.52–2.73) | P < 0.001 | |
| Major bleeding (transfusion, reintervention, or >20 g/L fall in hemoglobin) | 3.6% | 1.8% | 1.99 (1.40–2.81) | P < 0.001 | |
| Reintervention | 2.0% | 1.0% | 2.10 (1.32–3.35) | P = 0.003 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Optimal Timing of Perioperative Chemoprophylaxis in Patients With High Thromboembolic Risk Undergoing Major Abdominal Surgery: A Multicenter Cohort Study. Ann Surg. Published 5 September 2022. doi:10.
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